title: Surgical outcomes with 360-degree suture trabeculotomy in poor-prognosis primary congenital glaucoma and glaucoma associated with congenital anomalies or cataract surgery.
abstract: OBJECTIVE
  To evaluate the outcomes of 360-degree suture trabeculotomy in childhood glaucoma with poor prognosis.
  
  
  METHODS
  A nonrandomized, retrospective chart review was performed on pediatric patients (younger than 18 years of age) treated with a 360-degree suture trabeculotomy for glaucoma. The cases were categorized into the following groups: (1) primary congenital glaucoma with birth-onset presentation accompanied by corneal clouding noted at birth, (2) primary congenital glaucoma with onset or presentation after 1 year of age, (3) primary congenital glaucoma with previous failed goniotomy surgery, (4) infantile-onset glaucoma following congenital cataract surgery, and (5) infantile-onset glaucoma with associated ocular/systemic anomalies.
  
  
  RESULTS
  A total of 45 eyes of 33 patients were analyzed. The mean preoperative intraocular pressure (IOP) was 34.3±6.7 mm Hg on an average of 1.5 medications. Median age at time of surgery was 7 months. Mean final IOP (median last follow-up or failure, 12 months) was 22.2±7.1 mm Hg on an average of 1.5 medications. The probability of success according to time after surgery was 87% at 6 months, 63% at 1 year, and 58% at 2 years. Kaplan-Meier analysis of Groups 1-4 versus Group 5 failed to demonstrate a statistically significant difference (p=0.13). Of 5 eyes with port wine mark-related glaucoma, 2 had a large (>50%), persistent postoperative hyphema, and concurrent vitreous hemorrhage.
  
  
  CONCLUSIONS
  Children with a range of ocular pathologies can be successfully treated with 360-degree suture trabeculotomy. Further evaluation of this surgical technique in primary congenital glaucoma and open-angle glaucoma following congenital cataract surgery is warranted.
authors.affiliation: Department of Ophthalmology, Emory University Medical Center, Atlanta, Georgia 30322, USA. abeck@emory.edu
authors.forename: Allen D
authors.initials: AD
authors.lastname: Beck
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lynn
authors.forename: James
authors.initials: J
authors.lastname: Crandall
authors.forename: Omar
authors.initials: O
authors.lastname: Mobin-Uddin
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage; D002387:Cataract Extraction / Q000009:adverse effects*; D005124:Eye Abnormalities / Q000150:complications*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006871:Hydrophthalmos / Q000209:etiology / Q000601:surgery*; D007223:Infant; D007429:Intraocular Pressure / Q000502:physiology; D011379:Prognosis; D012189:Retrospective Studies; D013536:Suture Techniques; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents